Nursing Procedure Checklist

Starting an Intravenous Infusion

Instruction: Check under Correctly Done if identified skill is correctly performed; Incorrectly Done if
skill is not performed correctly; and Not Done if the student failed to perform the skill.
Procedure
1. Verify IV order against the physician order. Clarify any
inconsistencies. Check the patients chart for allergies. Check for
color, clarity, expiration date, etc.
2. Know techniques for IV insertion, precautions, purpose of the
IV administration, and medications if ordered.
3. Gather all equipment and bring to bedside.
4. Identify the patient. Ask the patient if allergic to any
medication, iodine, or tape, as appropriate. If considering using
an anesthetic (numbing) cream or 1% lidocaine injection, check
for allergies for these substances as well.
5. Explain the need for the IV and procedure to patient.
6. Perform hand hygiene. If using an anesthetic cream, apply
the anesthetic cream to a few potential insertion sites.
7. Prepare IV solution and tubing:
a. Maintain strict aseptic technique when opening sterile
packages and IV solution. Remove administration set from
package.
b. Clamp IV tubing, uncap spike on administration set, and
insert into entry site on IV bag or bottle as manufacturer
directs.
c. Squeeze drip chamber and allow it to fill at least halfway.
d. Remove cap at end of the IV tubing and while maintaining its
sterility, open the IV tubing clamp, and allow fluid to move
through tubing. Allow fluid to flow until all air bubbles have
disappeared and the entire length of the tubing is primed (filled)
with IV solution. Close clamp and recap end of tubing,
maintaining sterility of the setup.
e. If an electronic device is to be used, follow manufacturers
instructions for inserting tubing and setting infusion rate.
f. Apply label if medication was added to container (pharmacy
may have added medication and applied label). Label tubing
with date and time that tubing was hung.
g. Place time-tape on container and hang IV on pole.
8. Place patient in low Fowlers position in bed. Place protective
towel or pad under patients arm. Close the door to the room or
pull the bedside curtain.
9. Provide emotional support as needed.
10. Select and palpate for an appropriate vein. Avoid an arm
that has been compromised such as with presence of
arteriovenous fistula.
11. If the site is hairy and agency policy permits, clip a 2 area
around the intended site of entry.
12. Apply a tourniquet 3 to 4 above the venipuncture site to
obstruct venous blood flow and distend the vein. Direct the ends
of the tourniquet away from the site of entry. Make sure the
radial pulse is still present.
13. Instruct the patient to hold the arm lower than the heart.
15. Put on clean gloves.
16. If using intradermal lidocaine, cleanse insertion site with
alcohol using a circular motion. Inject a small amount (0.20.3
mL) of lidocaine into the area. If numbing cream was used,
wipe cream off insertion site. Cleanse site with an antiseptic
solution such as chlorhexidine or according to agency policy.
Use a circular motion to move from the center outward for

Correctly
Done

Incorrectly
Done

Not Done

Nursing Procedure Checklist

several inches.
17. Use the nondominant hand, placed about 1 or 2 below
entry site, to hold the skin taut against the vein. Avoid touching
the prepared site. Ask the patient to remain still while
performing the venipuncture.
18. Enter the skin gently, holding the catheter by the hub in
your dominant hand, bevel side up, at a 10- to 15-degree angle.
Catheter may be inserted from directly over the vein or the side
of the vein. While following the course of the vein, advance the
needle or catheter into the vein. A sensation of give can be
felt when the needle enters the vein.
19. When blood returns through the lumen of the needle or the
flashback chamber of the catheter, advance either device 1/8
to 1/4 farther into the vein. A catheter needs to be advanced
until the hub is at the venipuncture site, but the exact technique
depends on the type of device used.
20. Release the tourniquet as soon as possible. Quickly remove
the protective cap from the IV tubing and attach the tubing to
the catheter or needle. Stabilize the catheter or needle with
your nondominant hand.
21. Start the flow of solution promptly by releasing the clamp on
the tubing. Examine the tissue around the entry site for signs of
infiltration.
22. Secure the catheter with narrow nonallergenic tape (1/2),
placed sticky side up under the hub and crossed over the top of
the hub.
23. Place sterile dressing over venipuncture site. Agency policy
may direct nurse to use gauze dressing or transparent dressing.
Apply tape to dressing if necessary. Loop the tubing near the
site of entry, and anchor to dressing.
24. Label the IV dressing with the date, time, site, and type and
size of catheter used for the infusion on the tape anchoring the
tubing.
25. Remove all equipment and dispose of properly. Remove
gloves and perform hand hygiene.
26. Anchor arm to an armboard for support if necessary, or
apply a site protector or tube-shaped mesh netting over the
insertion site. Explain to patient the purpose of the armboard
and the importance of safeguarding the site when using the
extremity.
27. Adjust the rate of solution flow according to the amount
prescribed, or follow manufacturers directions for adjusting flow
rate on infusion pump.
28. Document procedure and patients response. Chart time,
site, device used, and solution.
29. Return to check flow rate and observe IV site for infiltration
30 minutes after starting infusion. Ask the patient if
experiencing any pain or discomfort related to the IV infusion.

Evaluated by: ________________________________ Date of Evaluation: ________________

(Signature over Printed Name)